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General NPI Number Information
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NPI Number | 1295206118
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Entity Type | Organization
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Legal Business Name | PEACE OF MIND COUNSELING AND EDUCATIONAL SERVICES
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 12/17/2018
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Provider Practice Location Address
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Address Line | 7901 CAMERON RD STE 2-239
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City | AUSTIN
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State | TX
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Zip | 78754-3814
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Country | US
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Telephone | 512-318-2503
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80233
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City | AUSTIN
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State | TX
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Zip | 78708-0233
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Country | US
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Telephone | 512-318-2503
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KENYA BOSON
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Credential | LPC
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Telephone | 512-318-2503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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